Dr. Stanley Goldstein - Author and Psychologist

A recent psychology listserv posting, referring to the layoff of federal workers, called it an "existential crisis." With which I must disagree! An existential crisis is a medical emergency or war situation and not unemployment though losing one's job is a major stress and one that all must learn to cope with. That unemployment can feel existential is another matter and that it can arouse depression and even physical symptoms is certain. But maturation means being able to consider matters in perspective. A job may feel like a supportive family that will provide sustenance for life but it is not.

I've had periods of unemployment and was once laid off from a government job with the union delegate stating that he'd never seen a government layoff before. But the county had financial problem, I was considered highly paid and so re-hired part-time.

All my periods of unemployment led to better results, as hopefully will happen with these laid-off workers. I've had patients who came to this country unable to speak English, learned it and more to earn more than many. I believe in the resilience of people, both youth and adults, which is a notion that seems to have become unpopular today. Nuff said.

The developmental origin of drug abuse has long been known. Early in life a child develops the basic ego capacities governing human functioning: the ability to control their thinking and behavior; the ability to modulate their mood; the ability to distinguish reality from fantasy; and their development of the sense of who they are or, as it is termed, their "sense of self."

No one experiences perfect parenting but if it was greatly inadequate a weakness of one or more of these capacities develop. This can cause difficulty with paying attention in school, socializing, and enabling later success with the critical development tasks of adolescence: dating, gaining appropriate separation from parents, and constructing realistic educational and vocational goals. These failings cause distress and, with some youth, the attempt to alleviate it using alcohol or drugs.

Substance abuse occasionally begins earlier or later but mostly during adolescence. Treatment is difficult because undergoing psychotherapy to heal the underlying personality issues that cause the substance abuse takes time while using a drug lessens pain quickly. The need for many episodes of in-patient treatment to become "clean" begins their life-long struggle to remain so. Longevity is not associated with substance abuse.

This article was inspired by my reading in The Wall Street Journal ("The Dark Side of Addiction Recovery for the Rich"/Feb. 16, 2025).

Few mental health subjects other than suicide contain more public misunderstanding. This article was incited by my county's mailed handout containing its risk indicators which include substance abuse, depression, and a family history of suicide. All being true though the major risk factors of suicide are the degree of self-control possessed, the presence of lethal means as a gun or drug, and if suicidal intent is present. Important facts were omitted, including reassuring ones such as depression (the "depressing" of feelings) being part of the human condition and commonly experienced when one struggles with an important personal decision.

While every expression of suicide should be professionally evaluated, its act is relatively rare when compared with its utterance. Virtually everyone hints of suicide sometime during their life ("I could kill myself") but relatively few do. Its incidence is like the proverbial needle in the haystack and why suicide prevention programs have questionable benefit though more public education about child psychological development and developmental psychopathology (a term coined long ago by my doctoral advisor) is certainly needed.

Suicide is motivated not by an immediate disappointment in love or work but from long-term despair: deep feelings of worthlessness derived from unsupportive parenting early in life. Then, at some future time, a major stress occurs, the early feelings of worthlessness resurrect and suicide is attempted. Because there is a biological imperative to live, alcohol or drug use is often present during this act.

A suicidal gesture is usually a cry for help, intended to gain the person their long resisted but needed treatment. And, contrary to another widespread belief, teenage cutting reflects self-hatred and the attempt to relieve stress rather than seeking death though accident can occur. Though certainly unwise, its real danger is the possibility of life-long scarring. Nuff said.

I once had a talented, highly accomplished friend who, a few minutes after asserting something, would say, "I never said that." Similarly, some children often deny responsibility for a misdeed despite evidence being apparent. In adults, this behavior has become understood in recent years as a selective impulsivity in an otherwise well-controlled person, they exhibiting such behavior only in selective areas of their life.

This usually reflects not an impulsive personality but contradictory impulses in particular areas of ife, perhaps those related to self-assertion or intimacy. As example, the person who is repeatedly sexually seductive only to quickly reject their partner to seek another "conquest." Another example is the person who lies impulsively but states lying is not a problem for them and accuses others of lying. These behaviors are emotionally disconnected from each other, being the essence of what is termed "compartmentalization."

The unconscious is very powerful and one must respect its power.

Sadly, false beliefs about childhood autism have become prominent today with many believing it derives from vaccination or air pollution or whatever. Yet psychologists have long known its origin, and why this knowledge is resisted by the public. Autism symptoms are perhaps the most visually disturbing of all mental health behaviors since it develops during the earliest years of life. But autism is also often misdiagnosed, and the presence of some autistic symptoms in a child often vanishes after brief play psychotherapy.

Autism is caused by a greatly deficient mother-infant interaction beginning in earliest infancy. The biological endowment of most infants enables their healthy development provided they experience an environment that meets their needs. For example, all babies will walk at the same general age even if they had been mostly carried by their mother. The pre-autistic baby, sensing the parenting inadequacies, seeks independence, an effort which must fail because of their age. This causes many such children to seem precocious at three years of age, until their attempt at autonomy collapses and an autistic shell develops as a protective mechanism. For effective treatment the therapist must enter the child's world and slowly wean them out. My intensive inpatient treatment, twice daily therapy for four years, of a teenage autistic child is described in my book, Troubled Children/Troubled Parents: The Way Out, the first chapter of which is posted on my website.

An Australian study found that when the mothers of young pre-autistic children were provided extensive counsseling about parent-child interaction, virtually none of these children were diagnosed as autistic at four. It is undeserved parental guilt which causes these facts to be ignored.

All parents believe they are doing the best for their children though none would consider this on any other task without instruction, which is publicly lacking. Thus parental guilt is unwarranted, particularly since the unconscious is very powerful. Sound parenting education could greatly benefit all.

This post was inspired by a Wall Street Journal article ("Stop Panicking Over Teens and Social Media"/Jan. 31, 2025) - The teenage (and younger) obsession with social media is not new, nor is it different from other compulsive behaviors that have long tormented parents. Though not inherently bad, its misuse can have life altering consequences and not for the better. I have known teen sexting activity to cost parents large legal fees, and grave consequences from this for adults too.
Psychologically, compulsive activity is a normal healthy mental mechanism when occasionally used to reduce anxiety. It is beneficial with scientific, creative, academic, or job activity but unproductive when interfering with these as when compulsively playing a video game instead of doing homework. An obsession is a repetitive thought (for example, the fear of not having locked the door) and a compulsion is the physical act of doing so (checking the door is locked).
Thus when a youth engages with social media obsessively it is because they are overly anxious, and the reason for this is what the parents should investigate, to remedy their child's distress with or without professional aid.
But education is important too since youth, being immature, do not grasp its potential harm or understand that what is posted today will publicly exist forever. Yet momentary impulsivity can cause adults to lose their way too. To think twice before posting is a good rule. And all, whether religious or not, should follow the Eleventh Commandment: Thou shalt not remove thy clothing in front of a camera!

In 2019 a 13-year-old British boy called a child welfare hotline and asked "What should I do if I want to kill somebody?" This year the 18-year-old did, murdering three girls at a dance class and trying to kill eight others and two adults who hoped to protect them. The police later found 164,000 documents and images on his digital devices, including images and videos of dead bodies, torture and beheadings, indicating his long obsession with killing. He downloaded an Al Qaeda training manual which included knife attack methods, and had made ricin, a biological toxin, that he kept in a lunchbox under his bed.

Teachers concerned about his interest in violence had reported him to authorities three times, when he was 13 and 14, without intervention since he was considered by them to be only crazed and not ideologically motivated. Diagnosed with autism at 14, he became increasingly reclusive, anxious, and aggressive in the years before the attack. He received mental health treatment for four years but "stopped engaging" with clinicians in 2023. His defense lawyer was reported to have said, in a statement which borders farce, that there was "no psychiatric evidence which could suggest that a mental disorder contributed" to his actions. With professional judgments like these, snails will soon take over the Earth.

Such killings are not rare, having occurred in Colorado Springs, Raleigh, Buffalo, Texas, Illinois, Serbia, Prague, Georgia, Wisconsin and most recently Nashville, I explaining the underlying motives in a previous article, "Understanding the Newtown Shooter," which is posted on my website (https://www.drstanleygoldstein.com/bio.htm). Sadly, knowledge of child psychological development is minimal among doctors, school personnel, and the general public, as is knowledge of developmental psychopathology, a term coined by my doctoral advisor decades ago. Nuff said.

This item was inspired by a Wall Street Journal Article ("Bill Gates: I Coded While I Hiked as a teenager. Was I on the Spectrum? Probably"/Jan. 24, 2025). There are fashions in labeling mental health disorders. A clinician confided that in his West Coast psychiatric hospital it was now forbidden to describe patients as "crazy," that the term "insane" must be used instead, and another that in his Washington DC hospital "crazy" was the preferred nomenclature with "insane" being forbidden. Similarly, the term "mentally retarded" has become abolished though without a favored accepted replacement. Or perhaps today all must be regarded as possessing genius lest feelings be hurt though both cognitive and physical abilities have long been known to follow the a bell curve, which is nature's way of saying that most people are about average.

During the newspaper interview, Gates was reported to have said that were he born today his obsessive interest in coding would be described as "neurodivergent," which has become the present term for children who were once termed "strange" or "weird." Even autism is now depicted as merely "neurodivergent," implying normality, though it is perhaps the most disabling of all mental health conditions, and often misdiagnosed.

Knowledge of child psychological development and developmental psychopathology (a term coined by my doctoral advisor decades ago) is minimal among both doctors and the general public.

The shocking suicide in May, 2024 of 30-year-old top golfer, Grayson Murray, stunned the golfing community. Diagnosed with social anxiety as a teenager, he battled distress for the rest of his life, perhaps not realizing that "social anxiety" is merely a description and not explanation for his unhappiness.
Suicide reflects complex motives deriving from early childhood during which one is made to feel worthless, a feeling that can resurrect during times of great stress. While almost all consider suicide at some point in their life, few do, the act being determined by whether suicidal intent (as contrasted with its mere thought) is present, the degree of self-control possessed, and if lethal means (as a gun or medication) are present. Though all such thoughts should be professionally investigated, the incidence of suicide when compared with its thought is like the proverbial needle in a haystack, which explains why suicide prevention programs tend to fail.
Because of the instinctive biological intent to live, when suicide does occur the use of alcohol or drugs is frequently involved.

Sadly, knowledge of child psychological development, which can prevent it early on, is minimal among doctors and the general public. One pediatrician, upon being told by his teenage patient that he was thinking of killing himself, responded, "You shouldn't talk like that. It upsets you mother." Nuff said.

News reports identified the murdered woman who was burned alive on a New York City subway as fifty-seven-year-old Debrina Kawam of Toms River, New Jersey. She had briefly stayed in a New York City homeless shelter despite her conventional early life. Forty-years before she was a high-school cheerleader with the public hope to be an airline stewardess and secret desire to "party forever." She was one of three girls voted to have a "million-dollar smile." Though working in her thirties as customer service representative for Merck, the giant pharmaceutical company, her life had been less than auspicious containing dozens of minor arrests for trespassing, public drinking, and disorderly conduct. She filed for bankruptcy in 2008 and her relationship with her romantic partner from 2011 to 2014 was chaotic.

The emotional conflicts precipitating Ms. Kawam's descent can only be speculated. At her father's death she described him as having been "the best father a daughter could have had" with the "regret that it took me later in life to figure that out." These statements may indicate that she ignored his sound advice. That alcohol abuse played a role seems likely in view of her many arrests for public drinking and disorderly conduct. Still, as with all troubled souls, she did her best, having lacked the needed support structure.
Yet while her burned body molders in the grave, her killer will enjoy for the remainder of his life, free food and health care and, in New York State prisons, a laptop, free college study (if desired), drugs (methadone) if he claims to be a drug abuser, and even a medical change of sex if sought.

Not fair. Not just. There is a justice of lawyers and the courtroom, and a justice of the Prophets and of God. Nuff said.